The glycocalyx generally covers almost all cellular surfaces, where it participates in mediating cell-surface interactions with the extracellular matrix as well as with intracellular signaling molecules. The endothelial glycocalyx that covers the luminal surface mediates the interactions of endothelial cells with materials flowing in the circulating blood, including blood cells. Cardiovascular diseases (CVD) remain a major cause of morbidity and mortality around the world. The cardiovascular risk factors start by causing endothelial cell dysfunction associated with destruction or irregular maintenance of the glycocalyx, which may culminate into a full-blown cardiovascular disease. The endothelial glycocalyx plays a crucial role in shielding the cell from excessive exposure and absorption of excessive salt, which can potentially cause damage to the endothelial cells and underlying tissues of the blood vessels. So, in this mini review/commentary, we delineate and provide a concise summary of the various components of the glycocalyx, their interaction with salt, and subsequent involvement in the cardiovascular disease process. We also highlight the major components of the glycocalyx that could be used as disease biomarkers or as drug targets in the management of cardiovascular diseases.

Hypertension is the leading cause of cardiovascular disease in women, and sub-Saharan African (SSA) countries have some of the highest rates of hypertension in the world. Expanding knowledge of causes, management, and awareness of hypertension and its co-morbidities worldwide is an effective strategy to mitigate its harms, decrease morbidities and mortality, and improve individual quality of life. Hypertensive disorders of pregnancy (HDPs) are a particularly important subset of hypertension, as pregnancy is a major stress test of the cardiovascular system and can be the first instance in which cardiovascular disease is clinically apparent. In SSA, women experience a higher incidence of HDP compared with other African regions. However, the region has yet to adopt treatment and preventative strategies for HDP. This delay stems from insufficient awareness, lack of clinical screening for hypertension, and lack of prevention programs. In this brief literature review, we will address the long-term consequences of hypertension and HDP in women. We evaluate the effects of uncontrolled hypertension in SSA by including research on heart disease, stroke, kidney disease, peripheral arterial disease, and HDP. Limitations exist in the number of studies from SSA; therefore, we will use data from countries across the globe, comparing and contrasting approaches in similar and dissimilar populations. Our review highlights an urgent need to prioritize public health, clinical, and bench research to discover cost-effective preventative and treatment strategies that will improve the lives of women living with hypertension in SSA.

Background: Escherichia coli (E. coli) is one of the most frequent causes of fatal bacterial infections affecting both humans and animals. The resistance to Carbapenems is mainly associated with enzyme-mediated resistance mechanism, through the acquisition of Carbapenemase genes. In Uganda, no studies have been done to detect presence of Carbapenem-resistant E. coli in sewage. We therefore carried out a study to characterize Carbapenem-resistant E. coli from sewage from Mulago National Referral Hospital. Methods and results: In this cross-sectional study, a total of 104, sewage samples were aseptically collected, cultured on MacConkey agar supplemented with Meropenem 1 µg/ml with other standard microbiology methods to screen for Carbapenem-resistant E. coli (CREC). Antimicrobial susceptibility testing was performed on the CREC, using Imipenem (10 mg/disc) and Meropenem (10 mg/disc), Carbapenem drugs readily available on market. Multiplex PCR was performed on selected Carbapenem-resistant and susceptible isolates to detect Carbapenemase genes. Later the isolates were pathotyped for virulence genes that included pathogenicity islands (PAIs) and phylogenetic markers. The results showed that the Carbapenem-resistant E. coli isolates were more resistant to Meropenem (64%) than Imipenem (60%). KPC gene was the most predominant (75%), followed by NDM gene (30%) while no OXA-48, IMP-1, and IMP-2 genes were detected. Pathotyping of virulence genes showed presence of eae gene, as the most predominant (40%), followed by elt gene (25%) and negative for stx and aggR genes. For PAI markers, only the PAI IV₅₃₆ gene was detected at 10%. Then, pathotyping of the phylogenetic markers was present in 85% of the typed isolates with yjaA gene the most abundant (60%) while both chuA and TSPE4.C2 were detected in 5% of the isolates. Conclusion: Both pathogenic and non-pathogenic Carbapenem-resistant E. coli strains are present in the sewage of Mulago National Referral Hospital in Uganda.

Human herpesvirus 8 (HHV-8) causes Kaposi's sarcoma (KS). Kaposi sarcoma in HIV/AIDS patients is referred to as epidemic KS and is the most common HIV-related malignancy worldwide. The lack of a diagnostic assay to detect latent and early-stage disease has increased disease morbidity and mortality. Serum miRNAs have previously been used as potential biomarkers of normal physiology and disease. In the current study, we profiled unique serum miRNAs in patients with epidemic KS to generate baseline data to aid in developing a miRNA-based noninvasive biomarker assay for epidemic KS. This was a comparative cross-sectional study involving 27 patients with epidemic KS and 27 HIV-positive adults with no prior diagnosis or clinical manifestation of KS. DNA and RNA were isolated from blood and serum collected from study participants. Nested PCR for circulating HHV-8 DNA was performed on the isolated DNA, whereas miRNA library preparation and sequencing for circulating miRNA were performed on the RNA samples. The miRge2 pipeline and EdgeR were used to analyse the sequencing data. Fifteen out of the 27 epidemic KS-positive subjects (55.6%) tested positive for HHV-8 DNA, whereas only 3 (11.1%) out of the 27 HIV-positive, KS-negative subjects tested positive for HHV-8 DNA. Additionally, we found a unique miRNA expression signature in 49 circulating miRNAs in epidemic KS subjects compared to subjects with no epidemic KS, with 41 miRNAs upregulated and 8 miRNAs downregulated. Subjects with latent KS infection had a differential upregulation of circulating miR-193a compared to HIV-positive, KS-negative subjects for whom circulating HHV-8 DNA was not detected. Further analysis of serum from epidemic KS patients revealed a miRNA signature according to KS tumor status and time since first HIV diagnosis. This study reveals unique circulating miRNA profiles in the serum of patients with epidemic KS versus HIV-infected subjects with no KS, as well as in subjects with latent KS. Many of the dysregulated miRNAs in epidemic KS patients were previously reported to have crucial roles in KS infection and latency, highlighting their promising roles as potential biomarkers of latent or active KS infection.

Carbapenem-resistant Klebsiella species have emerged as a major global public health threat, and hospital sewage acts as a crucial environmental reservoir for resistant strains that are known to cause infections associated with high rates of treatment failure and mortality. We aimed to characterize carbapenem-resistant K. pneumoniae isolated from sewage sites at Mulago National Referral Hospital. Isolated K. pneumoniae from sewage sites were subjected to antimicrobial susceptibility assays to determine their resistance to carbapenems. Multiplex PCR was performed on selected carbapenem-resistant isolates to detect the presence of five carbapenemase-encoding genes and to identify seven major serovars. The overall prevalence of carbapenem-resistant K. pneumoniae isolated from hospital sewage was 15.4%. Overall, the resistance rates to meropenem and imipenem were 81.3% and 62.5%, respectively. Multiplex PCR revealed that 68.8% of the isolates were positive for one or more carbapenemase-encoding genes, and the most predominant gene was bla_NDM (36.4%), followed by bla_IMP (27.3%), bla_VIM (23.7%), and then, bla_OXA-48, at 13.6%. No bla_KPC gene was detected. Capsular multiplex PCR revealed that 37.5% of the isolates were pathogenic, whereas 62.5% of the isolates were non-pathogenic; the predominant capsular antigen gene was wzyK2 (25%), followed by wzyK1 (6.25%), wzyK5 (6.25%), and wzyK54 (6.25%). This study detected the presence of carbapenem-resistant pathogenic and non-pathogenic Klebsiella environmental isolates, which pose a significant threat to the control of antimicrobial resistance. Further studies examining clinical isolates to identify sources of antimicrobial resistance and wider surveillance systems are required.

Background: Arsenic is one of the major toxic metals in the environment that is also known to be carcinogenic with several other health side effects in human beings. It can cause both acute and chronic toxicity depending on the doses available or duration of exposure in the human body. The major sources of arsenic exposure to humans include; via contaminated water, food and inhalation of arsenic dust from polluted air from car-fumes or industrial wastes and mining/ smelting grounds. Due to the fact that high levels of arsenic have been reported in rice from major rice-growing countries in Asia and rice being a major stapple food in Uganda, some of which is imported, this study aimed at determining the concentration of total arsenic in various rice brands sold in Uganda. Methods: Various rice brands weresampled from different supermarkets and grocery shops, taken to the laboratory and analyzed for arsenic using atomic absorption spectrometry. The arsenic concentration in the rice were determined following boiling or overnight soaking in plenty of water to see if these two approaches can help in significantly reducing the arsenic in the rice. The concentration of arsenic in the various brands of rice were compared using an unpaired t-test after setting a p-value of ≤0.05 as significant. Results: The York taste rice brand had the lowest arsenic levels of 1.4±0.0002 ppm and Zhong Yi rice brand had the highest levels of 2.4±0.004 ppm. The tap water used to boil, soak and wash the rice brands had much higher arsenic levels of 3.5±0.000003 ppm, which caused increased retention of the heavy metal in the rice. Conclusion: Rice brands sold in Kampala city seem to have higher than acceptable arsenic levels than what is recommended by WHO or American food and drug authority. The high levels of arsenic in tap water used in preparing the rice causes increased retention of the metal on boiling, soaking and washing. It is therefore, necessary to routinely monitor for arsenic levels in the rice on the market and domestic water sources so as to protect the general public from arsenic toxicity.